SMPA Membership Application

SMPA Membership Application
First Name*
Last Name*
Protected Address*
Santa Monica, CA 90402
Mailing Address
Contact Info
Primary Account Phone Number*
Cell #1
Cell #2
Work Phone #1
Work Phone #2
Email #1*
Email #2
Please enter your preferred start date for patrol services. If you start this month, the remainder of the month will be free. It may take a few business days for account setup to be completed.
Start Date (Month)*
Start Date (Day)*
How would you like to receive our required quarterly notifications/newsletter?*

EmailPaper copy to my mailing address

Patrol Information / Emergency Info
Patrol Officer Safety Information - Check any that apply:

There are/will be dogs on the propertyThere are/will be firearms on the property
Verbal code word*
Please specify a code word that ADT can use to positively identify you over the phone
Access Info:
Please note any information that patrol officers would need to access the perimeter of your home and/or your backyard if necessary during the course of their duties: (gate codes, key locations, etc):
Emergency Contact:*
Please list an emergency contact name and phone number (Dispatch will only call after they have exhausted all numbers previously listed)
REFERRAL BOX:
Patrol Officers receive a cash bonus for recruiting new members. If you joined as a result of a patrol officer contact, please list his/her name. If you don't have the name, please list any relevant info so SMPA can determine who made contact. (If you didn't join as the result of contact with a representative, we would appreciate any info you can briefly provide about what prompted you to join SMPA.)

Submit and Pay

Click below to submit your application, and you will be linked to an online payment page to make your prorated dues payment. Your dues payment will be prorated to align your expiration date with the rest of the SMPA members. At renewal time, you will be able to pay for a full year. Please note: The payment page is hosted by Clover, one of the most reputable names in commerce. Because we don't host the payment page on the SMPA website, your credit card number stays secure and protected. The number never passes through SMPA's hands at all - your credit card number is fully encrypted and SMPA is only given the last 4 digits for reference purposes. Make sure your browser allows you to navigate to an external link (clover.com) when you click to submit the application.
Should be Empty:

Contact Info